Revised Gynecomastia Anatomy and New Puffy Nipple Anatomy Pages

[DrBermant]

I have just revised my Anatomy of Gynecomastia.

I have added a new page on Anatomy of Puffy Nipples showing this more subtle version of male chest distortion.

These new drawings have changed to reflect a more realistic contour of the male breast.  I wanted to show how the gland in the body looks like the dermis layer under the skin and like the fascia covering the pectoral muscles and the connective tissue between.

I address more about the concepts here:
http://www.gynecomastia.org/smf/index.php?topic=14795.0

Take your time to review the different drawings I did about the various structures that make up the male chest and gynecomastia.  Learn more about fascia, the SFS Superficial Fascia System, Dermis, and gland by moving your cursor over the links or images.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction Surgery

[DrBermant]

I like this one better than the old one , but I have a question. In all the pictures the gland is like triangular pointing outward toward the nipple. Mine is more like a rigid ring type thing the middle is indented. I have seen a surgeon and he told me it was gynecomastia after doing an exam, ultrasound and hormone test. My hormones were within range, but not optimal for my age I just turned 26 a few days ago. Total testosterone was like 379 and estradiol was 32. I am seeing a endocrinologist in four days. During this time I was not eating or sleeping well and I was under a huge amount of stress as I thought I had breast cancer. I have always had a bigger than normal chest, but never any gland until about a year ago when it started growing. It is also worthy to note that I am 6'2" about 290 pounds. I have quit smoking, changed my diet and am now exercising regularly. The surgeon I saw specializes in oncology so I trust his opinnion. I am wondering yours though. Do you always order a biopsy on your patients or are there times you don't because you know it is not cancer. Originally I only had gland on the left side now it is growing on the right side. The first opinion that I got, basically the radiologist told me it looked suspicious, I need to get a biopsy and then he told me the treatment I would have to go through if it was cancer. The second opinnion was from the surgeon specializing in oncology he told me they had a bad reputation for scaring people into getting biopsies "it is how they make their money". At first it was unilateral now it is bilateral, meaning the gland was originally only on the left side now it is starting to form on the right side. Could this be the beginning of a larger triangular shaped gland like in your photos or is everyone different? I want to get surgery, but am going to wait a year to loose weight and get my hormones straight. Does gynecomastia grow outward? I have a gland under my nipple and like these finger type gland things coming off of it. My surgeon couldn't feel them or see them when he did the ultrasound.

 
Gland of gynecomastia comes in many different sizes and shapes. Here is Gland and hanging tissue for Male Mastopexy Gynecomastia.  And here is the Klinefelter Gynecomastia Gland removed.  You can find many other examples on my website.

It can be difficult to distinguish gland from fat on clinical exam.  That is why I evolved my Dynamic Technique.

I do not prefer ultrasound for my Labs and Diagnostic Tests for Gynecomastia.  I rarely order a Male Mammogram.  Each doctor has their own techniques and such issues are best explored during a consultation after an evaluation.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DrBermant]

Thanks it does help.

You are welcome.

I have just organized a new Picture Gallery of Gynecomastia Glands.  It is a slide show that has a navigation tool to jump to different sections of pictures.  Click on any of the pictures and you come to the web page describing the patient and his problems.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DrBermant]

DrBerman:

 The pictures of the glands you have posted on your website look the way mine feel, however mine feels indented in the middle. I am assuming the way they are laid out on the chest is where they were located. The "disc" under nipple is the smaller circular one correct? If you scanned it with an ultrasound would it look much darker than the surrounding tissue?

Gland of Gynecomastia as seen in this Picture Gallery comes in many different sizes and shapes.  Not only is it different from individual to individual, it is often different from the left to right sides.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Gyno 44]

Gland and hanging tissue for Male Mastopexy Gynecomastia

For that link you provided doc, is that one gland, or two gland from one breast ?  I know it says gland and tissue, but isnt gland tissue itself? What type of tissue did you remove from that person? The yellow thing is HUGE.  do you pull all that out of the same small incision, wouldnt pulleing something that large widen the scar?

[DrBermant]

Gland and hanging tissue for Male Mastopexy Gynecomastia

For that link you provided doc, is that one gland, or two gland from one breast ? The yellow thing is HUGE. What is the lard yellow thing, im confused on that, and do you pull all that out of the same small incision, wouldnt pulleing something that large widen the scar?

It depends on which example.  In the Male Mastopexy Chest Lift, the specimen consists of the gland and the extra tissue removed to lift up the drooping chest.  Use the navigation menu to see the different types of gland shown. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[Gyno 44]

Doc this page is amazing info, great examples i love it, ive been on the site before and dont remeber this, if its new then wonderful addition

[DrBermant]

Could the gland show up on an ultrasound? It did on mine and it was a different color than the surrounding tissue. Is this normal? It was much darker than the rest of the tissue and had well defined borders.

Gland can show up on ultrasound although this is something that is added by my radiologists when performing Male Mammograms when they need water / air definition such as cysts.  I normally do not order either for Testing for Gynecomastia.  Such issues are better discussed with the doctor who felt the need to order that testing and can talk with the people who performed the test.  When ultrasound testing is critical, I prefer to be there myself since the test is so subjective and seeing the results live are so much better.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[DrBermant]

Doc this page is amazing info, great examples i love it, ive been on the site before and dont remeber this, if its new then wonderful addition

Thank you, yes, these pages are recent additions and updates.

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Surgery